Provider Demographics
NPI:1851587455
Name:G. R. KAPOOR & S. R. OZA M.DS. INC.
Entity type:Organization
Organization Name:G. R. KAPOOR & S. R. OZA M.DS. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GOPALKRISHNA
Authorized Official - Middle Name:RAGHUNATHRAJ
Authorized Official - Last Name:KAPOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-252-8444
Mailing Address - Street 1:16111 LORAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5520
Mailing Address - Country:US
Mailing Address - Phone:216-252-8444
Mailing Address - Fax:216-252-7224
Practice Address - Street 1:16111 LORAIN AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5520
Practice Address - Country:US
Practice Address - Phone:216-252-8444
Practice Address - Fax:216-252-7224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045653207R00000X, 207RG0300X
OH35043533207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCK3114OtherRAILROAD MEDICARE GROUP PTAN
OH0444031Medicaid
OH0509300Medicaid
OH793111449OtherRAILROAD MEDICARE PIN
OH0435738Medicaid
OHC01949OtherUPIN
OH110146232OtherRAILROAD MEDICARE PIN
OHA79970OtherUPIN
OH9916374Medicare PIN
OHC01949OtherUPIN
OHCK3114OtherRAILROAD MEDICARE GROUP PTAN